DS-15-2006 Inspection Worksheet
Miami Shores Village
10050 N.E.2nd Avenue Miami Shores,FL
Phone: (305)795-2204 Fax: (305)756-8972
Inspection Number: INSP-255830 Permit Number. DS-8-15-2006
Scheduled Inspection Date: March 30,2016 Permit Type: Driveways/SidewalksJSiabs
Inspector Rodriguez,Jorge Inspection Type: Final
Owner. CAMP,JOHN Work Classification: New
Job Address:1050 NE 96 Street
Miami Shores FL
Phone Number (305)530-0050
Parcel Number 1132060143520
Project <NONE>
Contractor. CHAMPION CONCRETE Phone: 305 252-8055
( )
Building Department Comments
PAVERS DRIVEWAY Infractlo Passed Comments
INSPECTOR COMMENTS False
Inspector Comments
Passed CREATED AS REINSPECTION FOR INSP-241009. Paver connection with
curb should be flush with the concrete.
Failed
Correction a
Needed
Re-Inspection ❑
Fee
No Additional Inspections can be scheduled until
re-Inspection fee is paid
March 29,2016 For Inspections please call: (305)762-4949 Page 37 of 39
Miami Shores Village
10050 N.E.2nd Avenue NE `
•ny� '� -t jYc'`"€i lain' d t t .St{!i T!!
Miami Shores,FL 33138-0000
Phone: (305)795-2204
WN
Ex Iration: 0 /0412016
Project Address Parcel Number Applicant
1060 NE 96 Street 1132060143520
JOHN CAMP
Miami Shores, FL Block: Lot:
Owner Information Address Phone Cell
JOHN CAMP 1050 N.E.,96 ST. (305)530-0050
-- i
Contractor(s) Phone Cell Phone Valuation: $ 7,560.00
CHAMPION CONCRETE (305)252-8055 (786)402-4802...___r Total Sq Feet: 960
Approved:In Review Available Inspections:
Comments: Inspection Type:
Date Approved::In Review Final
Date Denied: Foundation
Type of Work:PAVERS DRIVEWAY Additional Info: Review Planning
Bond Retum: Classification:Residential Review Building
Scanning:3 Review Building
Fees Due Amount Pay Date Pay Type Amt Paid Amt Due
Bond Type-Owners Bond $500.00 Invoice# DS-8-16-56660
CCF $4.80 08/10/2015 Check#:1971 $50.00 $600.80
DBPR Fee $2.00
DCA Fee $2.00 11/06/2015 Check#:2219 $500.00 $100.80
Education Surcharge $1.60 11/06/2015 Credit Card $100.80 $0.00
Permit Fee $125.00 Bond#:2901
Scanning Fee $9.00
Technology Fee $6.40
Total: $650.80
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans,drawings,statements or specifications submitted to the proper authorities of Miami Shores Village. In
accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate permits are
required for ELECTRICAL,PLUMBING,MECHANICAL,WINDOWS,DOORS,ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurst aqd that all work will be done in compliance with all applicable taws regulating
construction and zoning. Futhermore,I authorize the above-named contracto to'do th rk stated.
November 06,2015
Authorized Signature:Owner / Applicant / Contractor Agent ate
Building Department Copy
November 06,2015 1
Miami Shores Village 'ED
Building Department artment AUG 1 205
10050 N.E.2nd Avenue,Miami Shores,Florida 33138
Tel:(305)795-2204 Fax:(305)756-8972 T(,
INSPECTION LINE PHONE NUMBER:(305)762-4949
FBC 201`-4
BUILDING Master Permit No. VS '
PER IT APPLICATION Sub Permit No.
BUILDING ❑ ELECTRIC ❑ ROOFING REVISION EXTENSION ❑RENEWAL
❑PLUMBING ❑ MECHANICAL ❑PUBLIC WORKS CHANGE OF ❑ CANCELLATION ❑ SHOP
CONTRACTOR DRAWINGS
JOB ADDRESS:
City: Miami Shores County: Miami Dade Zip: �_7/1W
Folio/Parcel#: it 32-06— 0!q^ Is the Building Historically Designated:Yes NO
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER:Name(Fee Simple Titleholder): '� � /�- �/AJ�'L�U Phone#:
Address: 1117.,50 Nom' ab51—
City: IANNS 4W_hjYi State: Zip: F3133
3
Tenant/Lessee Name: Phone#:
Email:
CONTRACTOR:Company Name: 64f JaAfb I wj Phone#:-_704� z5;?_gpg57
Address:l/n of W dS 5 c r
City: State: Zip:
Qualifier Name: W,� . Phone#:7�6�
State Certification or Registration#: Certificate of Competency#:
DESIGNER:Archl'tect/1ngineet Phone#:
Address: City: State: Zip:
Value of Work for this Permit:$ Square/linear Footage of Work: 17 (/d�-s E
Type of Work: ❑ Addition ❑ Alteration ❑-New ❑ Repair/Replace ❑ Demolition
Description of Work: "Xbft f'
1,4
®11 96 9761a %# t 4;(Woo
Specify color of color#6ru Vla� , to aanMx mm0 q '•044 ,��;Submittal Fee$ Permit Fee$ 1� r6W of
Scanning Fee$ Radon Fee$ DBPR$ Notary$
Technology Fee$ Training/Education Fee$ Double Fee$
Structural Reviews$ Bond$ ��M
TOTAL FEE NOW DUE$ 10 Q GO
(Revised02/24/2014) GD
IJ
1
Bonding Company's Name(if applicable)
Bonding Company's Address
City State Zip
Mortgage Lender's Name(if applicable)
Mortgage Lender's Address
City State Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES,BOILERS,HEATERS,TANKS,AIR CONDITIONERS,ETC.....
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING
YOUR NOTICE OF COMMENCEMENT."
Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding$2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also,a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence f such posted notice, the
inspection will not be approved and a reinspection fee will be charged.
Signature Signature
OWNER or AGENT CONTRACTOR
The foreg Ing inst ment was acknowledged befo a this The foregoing instrument was acknowledged before me this
13" day of ��20 l � ,by /O day of iAV6VS� ,20 � ,by
14 who is personally known to '--�A7 Mp 16l�'S1 0 who is personally known to
me or who has produced as me or who has producedAtg�O��* as
identification and who did take an oath. identification and who did take an oath.
NOTARY PUBLIC: NOTARY PUBLIC:
Sign: dcj Q-0
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Print: Print:
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Seal: E,"M Seal: dSSION9FF17201g
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APPROVED BY Plans Examiner Zoning
Structural Review Clerk
(Revised02/24/2014)
5 ° Miami Shores Village
also Building Department
10050 N.E.2nd Avenue
`^ "w Miami Shores, Florida 33138
WQ m Tei: (305) 795.2204
Fax: (305) 756.8972
COVENANT OF CONSTRUCTION WITHIN RIGHT OF WAY
Whereas, (owner) .., OH/V 4 hereinafter referred to as the owner of
the following described properly(address): �t� ( 1V'�� q4 n�
h t�nJG �s 1- 3_30-y
Legal Description Lot Block Subdivision
Folio#
Requests permission to install(describe work):
Within the public right of way of(address)
INCONSIDERATION of the approval of this permit by the Villagetha ownr, gr r`e s asciws <
1. To maintain and repair,when necessary,the above-mentioned item(s) installed within the dedicated right of
way. If it becomes necessary for Miami Shores Village or Dade County to make repairs or maintain said
items within public right of way including restoration of street by reason of the Owner's failure to do so,
such expense shall be paid by the Owner or shall constitute a lien against the above described pragerty
• • •••• ••••••
•
until paid. •••• •• •
2. The owner does hereby agree to indemnify and hold Miami Shores Village or Dade Gawhharmless from any ;....:
and all liability,which may rise by virtue of permitting the installation of these items whiRkIl a public right of way":".
•
• •
1
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3. The Owner does hereby agree to remove or relocate their facilities at their own expense,within 60 days
notice by the Village to do so. Failure to comply with this notice will result in the Village causing the item(s)
to be removed and a lien being placed on the property and/or assessed against the Owner for all costs
incurred in the removal and disposal of the item(s).
4. The undersigned further agrees that these conditions shall be deemed a covenant running with the land
and shall remain in full force and effect and be binding on the undersigned,their heirs and assigns, until
such time as this obligations has been canceled by an affidavit filed in the Public Records of Dade County,
Florida by the Village Manager of Miami Shores Village (or his fully authorized representative).
SIGNED, SEALED, EXECUTED AND ACKNOWLEDGE on this day of vib ar ,201
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(Owner's S' natu )
SIGNED, ED, D DELIVERED in the presence of:
,P- , &beco � Rt6 1 L
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Notary PUMIC-State of FWW&
Commission*FF 228812
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